MARK DAVID WAGNER


Address: 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878
Phone: 2066200333

MARK DAVID WAGNER (NPI# 1649211764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649211764
Entity Type Individual
Full Name MARK DAVID WAGNER
Credential M.D.
Practice Address 1000 Dexter Ave N Ste 320
Seattle
WA 98109-4878
Practice Telephone 2066200333
Practice Fax Number 2064627520
Mailing Telephone 2066200333
Mailing Fax Number 2064627520
Enumeration Date 2006-06-09
Last Update Date 2019-05-07
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
MD00022633 WA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WA LABOR AND INDUSTRY 378219 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
1000 Dexter Ave N Ste 320, Seattle, WA 981094878 2066200333 2064627520

Other Providers MARK WAGNER

NPI Name Taxonomy Address Enumeration
1528419074 Mark Vincent Wagner Dentist 2600 Village Pkwy Ste 120, Highland Village, TX 75077-3285 2016-06-27
1467845487 Mark Wagner Health Educator 600 Cornell Ave, Hagerstown, MD 21742-4500 2015-03-16
1265863112 Mark Wagner Dentist 24 Old Plantation Way, Pikesville, MD 21208-6375 2013-12-03
1881967016 Mark Allen Wagner Physical Therapist 4046 Arezzo Dr, Longmont, CO 80503-4157 2012-02-19
1780737924 Mark Wagner Psychologist 23 Pokonoket Ave, Sudbury, MA 01776-2320 2007-01-19
1033202502 Mark Elliot Wagner Family Medicine 623 North 5th Street, Reading, PA 19601 2006-10-02
1700821709 Mark S Wagner Psychiatry & Neurology 515 Cabrillo Park Dr, Suite 120, Santa Ana, CA 92701-5016 2006-06-17
1336130087 Mark Andrew Wagner Radiology 2740 M St, Merced, CA 95340-2813 2005-11-02
1992358741 Mark Wagner Counselor 540 Riverside Dr Ste 8, Salisbury, MD 21801-5352 2019-07-22
1134488752 Mark E Wagner Counselor 900 W Norfolk Ave, Norfolk, NE 68701-5006 2012-05-16

Office Location

Street Address 1000 DEXTER AVE N STE 320
City SEATTLE
State WA
Zip Code 98109-4878

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497356158 Rachel E Tarkowski Dietitian, Registered 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878 2020-11-07
1962927632 Therapy Management Services, Pllc Physical Therapist 1000 Dexter Ave N Ste 320, Seattle, WA 98109-3582 2017-08-03
1104244045 Amy Colten Physical Therapist 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878 2014-03-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710590179 Direct Urgent Care Inc Internal Medicine 220 6th Avenue North, Seattle, WA 98109 2020-08-26
1073147104 Hannah Christine Hoyt Registered Nurse 1354 Aloha St, Seattle, WA 98109 2020-02-27
1508402645 Emily Elizabeth Rock Counselor Rain City Integrative Clinic, 2730 Westlake Ave N, Seattle, WA 98109 2019-11-25
1770048464 Roger Leach Massage Therapist 4162, Roy Street, Seattle, WA 98109 2019-02-06
1306316658 Laura Katie Richer Counselor 1817 Queen Anne Ave. N., 204, Seattle, WA 98109 2018-11-29
1912492828 One Medical Group of Washington, P.C. Psychologist 625 Boren Avenue North, Seattle, WA 98109 2018-06-25
1942793526 Washington Dental Corporation, PC Dentist 527 Boren Ave N, Seattle, WA 98109 2018-06-08
1417449968 Chelsie Mccalla Occupational Therapy Assistant Mirabella, 116 Fairview Ave N, Seattle, Seattle, WA 98109 2018-05-31
1710405964 Next Level Sports Performance Consulting Clinic/Center 24 Roy Street, #461, Seattle, WA 98109 2017-09-07
1679091953 Amy Ly Indorf Pharmacist 825 Eastlake Ave E #msg5-90, Seattle, WA 98109 2017-09-06
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Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497173991 Ashley Austin Family Medicine 1959 Ne Pacific St, Seattle, WA 98195-0816 2014-04-01
1871859942 Brian Kenneth Snitily Family Medicine 601 Broadway Fl 6, Seattle, WA 98122-5330 2012-04-03
1316142862 Emily L Cooper Family Medicine 400 N 34th St, 300, Seattle, WA 98103-8600 2007-06-15
1063563229 Maxine J. Weyant Family Medicine 901 Boren Ave, Suite 900, Seattle, WA 98104-3595 2007-01-15
1629177225 Sports Medicine Group Family Medicine 10330 Meridian Ave N, Suite 300, Seattle, WA 98133-9451 2006-09-21
1659487056 Jordan S D Y Chun Family Medicine 1100 9th Ave, Seattle, WA 98101-2756 2006-08-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326565110 Family Care Network, Pllc Family Medicine 3130 Squalicum Pkwy Ste 110, Bellingham, WA 98225-1940 2017-08-23
1578682100 Robert Stewart Nicol Family Medicine 23512 Ne 206th St, Battle Ground, WA 98604-9699 2007-03-28
1912033663 Richard Terril Jacobs Family Medicine 1351 Fowler St, Richland, WA 99352-4714 2007-02-26
1821132481 James E Hult Family Medicine 800 N 5th Ave # 101, Sequim, WA 98382-3045 2007-02-16
1598874430 Patrick Z Pearce Family Medicine 730 N Hamilton St, Spokane, WA 99202-2045 2006-08-30
1265450514 Lawrence J Greenblatt X Family Medicine 1407 116th Ave Ne Ste 102, Bellevue, WA 98004-3819 2006-07-17
1528015229 Public Hospital District #1 of King County Family Medicine 3600 Lind Ave Sw, Suite 170, Renton, WA 98055-4934 2006-05-28
1063486074 Warren Billings Howe Family Medicine 516 High St, Wwu Student Health (ms-9132), Bellingham, WA 98225-5946 2006-02-15
1588280804 Rainier Family and Sports Medicine P C Family Medicine 16202 64th St E Ste 104, Sumner, WA 98390-3028 2020-06-23
1417469404 Maksportsmd Family Medicine 19110 Bothell Way Ne Ste 102, Bothell, WA 98011-2970 2017-10-30
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Competitor

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City SEATTLE
Zip Code 98109

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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